Correlation of reaching and grasping kinematics and clinical measures of upper extremity function in persons with stroke related hemiplegia

Abstract

Timed measures of standardized functional tasks are commonly used to measure treatment effects in persons with upper extremity (UE) paresis due to stroke. The effectiveness of their ability to measure motor recovery has come into question because of their inability to distinguish between motor recovery and compensations. This paper presents three linear regression models generated from twelve kinematic measures collected during the performance of a two phase reach/grasp and transport /release activity as performed by 21 persons with upper extremity hemiparesis due to chronic stroke. One of these models demonstrated a statistically significant correlation with the subjects' scores on the Wolf Motor Function Test (WMFT), a battery of fifteen standardized upper extremity functional activities. The second and third models demonstrated a statistically significant correlation with the subjects' WMFT change scores elicited by a two week intensive upper extremity motor rehabilitation intervention. The high correlation suggests that models of kinematic measurements can be used to predict neurologic improvement and the effectiveness of treatment.

Figures

Figure 1

Reaching test schematic: Trial begins with hand at rest, placed in initial preset position. At cue, subject reaches for the object, places it on a 7.5 cm high target platform, and returns to initial position.

Figure 2

Model # 1 WMFT Scores predicted with a model using all twelve kinematic measurements, major contributors were: RETR and TTTL. Higher numbers indicate slower times / worse performance.

Figure 3

Model # 2 WMFT Change Scores predicted with a model using change scores for all twelve kinematic measurements, (major contributors were: RHTS and TTL) vs. actual WMFT change scores. Positive numbers correspond with functional improvement.

Figure 4

Model # 3 WMFT Change Scores predicted with a model using all twelve kinematic measurements collected at initial measurement (major contributors were: RTS, TTS and RFE) vs. actual WMFT change scores. Positive numbers correspond with functional improvement.